Honors Program


Date of this Version

Spring 3-12-2018

Document Type



Young, Kelsey. Expiratory Muscle Strength Training: Devices and Outcomes. University of Nebraska-Lincoln. 2018


Copyright Kelsey Young 2018


This study examined the pressure required and resistance provided by four expiratory muscle strength training (EMST) models and one related model. EMST purports to strengthen the muscles used during exhalation that are required for respiration, coughing, speech, and swallowing. The investigator produced three minimum to maximum and three maximum to minimum breath trials at each chosen or available setting for two devices of each of five models. Data were extracted for each point at which flow initiated or ceased during each trial. Mean trigger pressures and standard deviations were calculated for each model and each setting within the model. Of the models tested, the EMST150 had the highest minimum trigger pressure values and the greatest variability. The Acapella device provided the most stable pressures and predictable increments of increasing resistance across the device settings. The TheraPEP, original version of The Breather, and new version of The Breather produced reasonably high reliability but required a small range of differing pressures between the highest and lowest resistance settings. These data provide preliminary selection parameters for clinicians seeking a model that fits a particular client’s abilities and needs.